The goal of this cohort study is to evaluate the safety and potential impact of an active strategy that allows paramedics to assess very low-risk trauma patients with the Canadian C-Spine Rule (CCR) and transport them to the Emergency Department without immobilization. The specific objectives of the study are to determine safety, determine the clinical impact and evaluate performance.

Performance of the Canadian C-Spine Rule [ Time Frame: Rule accuracy will be within 30 days of enrollment. Paramedic accuracy of interpretation and agreement will be assessed immediately following enrollment. ]

Measurements of the performance of the rule will include:

rule accuracy

paramedic accuracy of interpretation

paramedic agreement and level of comfort with the decision suggested by the Canadian C-Spine Rule

Scene Time [ Time Frame: immediately following evaluation ]

Time spent at scene (difference between Paramedic scene departure and arrival at patient side)

Average Contact Time [ Time Frame: immediately following evaluation ]

Total time spent with patient (Defined as difference between Transfer of Care and Arrival at Patient Side)

Paramedics will use the Canadian C-Spine Rule to evaluate low-risk trauma patients meeting the study inclusion criteria in order to determine the need for spinal immobilization for transport to the hospital.

Procedure: Canadian C-Spine Rule

Paramedics will apply a validated decision rule (the Canadian C-spine Rule) to determine whether or not immobilization is required for trauma patients being transported to the emergency department.

Eligibility

Ages Eligible for Study:

16 Years and older (Child, Adult, Senior)

Sexes Eligible for Study:

All

Accepts Healthy Volunteers:

No

Criteria

Inclusion Criteria:

consecutive alert, stable adults evaluated by the paramedics with potential c-spine injury after sustaining acute blunt trauma. Patient eligibility will be determined at the time of paramedic arrival at the scene based on the following criteria:

"Potential c-spine injury after sustaining acute blunt trauma" will include patients with either:

neck pain with any mechanism of injury (subjective complaint by the patient of any pain in the posterior aspect of the neck),

no neck pain but some visible injury above the clavicles, and/or

neither neck pain nor visible injury, but significant mechanism of injury as determined by the paramedic at the scene.

Patients referred from another hospital and transported between facilities.

Contacts and Locations

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study.
To learn more about this study, you or your doctor may contact the study research staff using the Contacts provided below.
For general information, see Learn About Clinical Studies.

Please refer to this study by its ClinicalTrials.gov identifier: NCT01188447